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Home My WebLink AboutBlde-20-000773 Commonwealth of Official Use Only Permit No. BLDE-20-000773 Massachusetts BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:8/12/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the e ctrical work descr'be d below. Location(Street&Number) 98 KATES PATH VILLAGE SION Owner or Tenant D Telephone No. Owner's Address 9E-Y-S31.1146—VtItelfaX10, 98 KATES PATH,YARMOUTH PORT, MA 02675-1449 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement furnace. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of Gas Burners 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertinc Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Gary L Gordon Licensee: Gary L Gordon Signature LIC.NO.: 15290 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:37 BILLINGSGATE DR, DENNIS MA 026382234 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 Occ /( cec / r `/ ��j/ l.ommoruveelth of///assachu.dafts Official Use Only 1. _ / x c7 i7 3 �� _ `—UaParfmt,st al Permit No��li__ Q 7 o Micas _=` • Occupancy and Fee Checked • b(lif (��jt • BOARD OF FIRE PREVENTION REGULATIONS "Rev. 1/07J (leave blank)APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code ),527 12.00 1vAf (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: g /` City or Town of: YARMOUTH To the Insp ctor f Wires: By this application the pndersigned gives notice of his or h intention to rfo a electrical work described below. CLocation (Street&Number) 9 4 . r P� Owner or Tenantg9o-eit4 r/'--f se- ^'T ` Telephone p e Na. er's Address 5-et-� 0 is is permit in conjunction with a 1U)7 ilding permit? Yes ❑ No ❑ (Check Appropriate Box) u ose of Building �(^J,EUtility Authorization No. / �'�zi -ng Service��!/ Amps/�0"��Volts Overhead � Undgrd❑ No.of Meters uI O Service Amps / Volts Overhead❑ Undgrd '�► gr ❑ No.of Meters S r of Feeders and Ampacity /k/ Y7 e, ,�Cj j ft 1�i, /_ q Q 'on and Nature of P ed lectri ork: LLI� m ce Completion of the following table may be waived by the Inspector of FFires. No.of Recessed Luminaires No.of Cet1-Sizsp.(Paddle)Fags No.of Total Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA v No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting Fred , grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones �p No.of Switches No.of Gas Burners No.of Detection and Initiation Devices Total _ No.of Ranges No. of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingMunicipal KW' Local Q Connection ❑ er 2 No.of Dryers Heating Appliances ,4, Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters ' No.of Data Wiring: _,V Signs Ballasts No.of Devices or Equivalent t No.Hydromassage Bathtubs OTHER: No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent 5/' f Attach additional detail ifdesired or as required by the Inspector of WiresEstimated Value of E ctrial Work (When required by municipal policy.) N. Work to Start: • 9 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent, The O undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. Q CHECK ONE: INSURANCE X BOND 0 OTHER ❑ (Specify:) I certzfy, under the pains and penalties of perjury,that the information on this application is true and complete .A NAME: p p d-Sdp1,_.f"E/e r t G f� LIC.NO.: I io2 9'e, Licensee: 'it or rd Signature (If applicable,enter "es mpt"ip t e license number 1' e.) LIC.NO.: . Address-. 37 a//// 7 'Via/tie n f rn9 Bus.TeL No.: J *Per M.G.L. c. 147,s.57-61,>securfty rk requires Department of Public Safety1S"License: Alt.Lic.No. - OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one 0 owner 0 owner's a Owner/Agent Signature Telephone No. PERMIT FEE: $